The treatment of absolutely any mental disorders must be carried out under the close supervision of a qualified doctor. One of the most common drugs used in psychiatric practice is Amitriptyline.
This medicine belongs to the group of antidepressants. It is worth noting that you can only purchase it by prescription.
Features of the drug
Many patients are interested in why Amitriptyline tablets help, and how to use them exactly. This medicine has anxiolytic, antidepressant, sedative and timoleptic qualities. Its use makes it possible to reduce the feeling of anxiety, excited state and excitement, as well as eliminate and significantly reduce the manifestation of depression.
The drug "Amitriptyline" has a cumulative effect, which means that the antidepressant effect will become noticeable only after 2-3 weeks from the start of therapy. Patients need to know that when you stop taking the drug, there is a high probability of withdrawal syndrome.
Doctors prescribe the drug Amitriptyline to correct a number of pathological conditions. It is often used in the treatment of depression, especially those that are characterized by severe anxiety.
The drug helps to effectively deal with endogenous depressive states. It is prescribed for patients with neurotic disorders, as well as those who have developed against the background of various kinds of brain damage or taking certain medications. It also copes well with schizophrenic psychoses.
According to the instructions for use, "Amitriptyline" is used to treat enuresis in childhood, if this disease arose against a background of impaired functioning of the bladder. This drug also helps to effectively cope with chronic pain.
Composition and form of release
Ampitrilin is available in 10 tablets with a dosage of 25 mg per blister. Each carton contains 5 blisters, each containing 10 tablets. 1 tablet contains 25 mg of amitriptyline hydrochloride.
In addition, the drug also contains auxiliary substances, in particular, such as microcrystalline cellulose, titanium dioxide, talc.
Indications for use
According to the instructions for use, "Amitriptyline" is used mainly to eliminate depressions of an endogenous, involutional, reactive, medicinal nature. In addition, the drug is prescribed for depression that occurs against the background of alcohol abuse, organic brain damage, accompanied by anxiety and sleep disturbance. Among the indications of "Amitriptyline", it is necessary to highlight such as:
- emotional mixed disorders;
- schizophrenic psychoses;
- bed-wetting;
- violation of behavior;
- chronic pain.
Among chronic pains, it is necessary to distinguish such as migraine, post-traumatic and diabetic neuropathy, atypical, rheumatic pain, postherpetic neuralgia. Among the indications of Amitriptyline, it is also worth highlighting the presence of peptic ulcers, headaches, and migraine prophylaxis.
Some studies have proven the effectiveness of this drug in the treatment of digestive tract disorders. As an addition to the main regimen for the use of stimulating drugs, Amitriptyline is prescribed for hyperactivity.
As a result of the use of this drug in patients:
- mood improves;
- the feeling of anxiety, emotional stress is reduced;
- lethargy and apathy will be eliminated;
- sleep and appetite normalize.
It is worth noting that "Amitriptyline" is not dispensed without prescriptions, as it is a powerful sedative that has various side effects and contraindications.
Dosage and administration
According to the instructions for use of "Amitriptyline" for depression, adults are initially prescribed 25 mg of the drug 3 times a day with a gradual increase in dosage. If necessary, the use of 150 mg per day is required, and in a hospital setting, the maximum dosage can be 225-300 mg per day. The maintenance dose of "Amitriptyline" is equal to the optimal therapeutic.
People over 65 are initially prescribed a drug in a dosage of 10 mg 3 times a day, and then it needs to be gradually increased. If necessary, every second day 100-150 mg are prescribed. An additional dose is mainly prescribed for evening use. If it is necessary to use the drug in a dosage of 10 mg, the doctor may prescribe another dosage form that corresponds to it. A dose above 150 mg is recommended to be used only in a hospital setting.
Treatment with Amitriptyline should be quite long, since the antidepressant effect occurs mainly only after 2-4 weeks from the start of the drug. Antidepressant therapy is exclusively symptomatic, and therefore must be carried out within an appropriate period of time. Basically, treatment is required for 6 months after full recovery in order to prevent the development of relapse.
In patients with recurrent depression, maintenance therapy may be required for several years to prevent the recurrence of the problem. In the presence of chronic pain, adults are prescribed 25 mg of the drug in the evening. Dosage may be gradually increased according to the expected effect of therapy. The maximum possible dosage is 100 mg in the evening. To treat people of advanced age, doctors advise starting treatment at about half the recommended dose.
According to the instructions for use "Amitriptyline" for enuresis, children aged 7-10 years are prescribed in a dosage of 10-20 mg, in 11-16 years old - 25-50 mg at night. The maximum duration of therapy is no more than 3 months. In patients with impaired renal function, the medicine can be taken in normal dosages. Careful dose selection is recommended for patients with reduced liver function.
Increasing the dosage is mainly carried out by taking the medicine in the evening or at bedtime. When conducting maintenance therapy, the total daily dosage can be taken once, preferably before bedtime. Stop discontinuing the drug gradually, reducing the dosage of the drug for several weeks.
In case of signs of depression with a decrease in the usual dose, you need to return to the previous course of therapy. If the patient's well-being does not improve within 3-4 weeks from the start of therapy, then subsequent treatment will be inappropriate.
With severe depressions, it is necessary to administer the drug intravenously or intramuscularly in a dosage of 10-30 mg up to 4 times a day. The dosage should be increased gradually, and after 1-2 weeks you need to switch to taking the drug in tablet form.
Side effect
Before using Amitriptyline, contraindications and side effects need to be studied first of all, since there are certain restrictions on taking this medicine. Among them, it is necessary to highlight such as:
- constipation;
- increase in pressure;
- bowel obstruction;
- dry mouth
- drowsiness.
In addition, patients may experience the following side effects of Amitriptyline:
- violation of the nervous system;
- digestive upset;
- deterioration in the functioning of the cardiovascular system;
- endocrine disorders;
- allergies.
According to patients' reviews about taking this medicine, some had a rash and other signs of allergy. This drug is prescribed with caution to people with manic psychosis, since there is a high probability of the disease becoming a manic stage.
In addition, it is worth remembering that the use of Amitriptyline in tablet form with a daily dosage of more than 150 mg can lead to a decrease in the maximum threshold for convulsive activity. That is why patients who previously had convulsive seizures, as well as those patients in whom they may occur as a result of injuries, need to consider the likelihood of seizures.
Contraindications
There are also certain contraindications to the use of this medicine, which is why Amitriptyline is not sold without prescriptions prescribed by the attending doctor. Among the main contraindications, it is necessary to highlight such as:
- heart failure;
- heart attack;
- arterial hypertension;
- disturbances in the electrical conduction of the heart muscle;
- acute damage to the kidneys and liver;
- prostatic hypertrophy;
- bowel obstruction;
- peptic ulcer;
- pregnancy and lactation;
- children under 6 years old;
- hypersensitivity to the active substances of the drug.
Very carefully, you need to take this drug for people suffering from alcoholism, depressive psychosis, epilepsy, hyperthyroidism, bronchial asthma, schizophrenia. It is worth noting that when it is taken, there is very rarely an exacerbation of the symptoms of existing diseases. If the use of the drug is required during lactation, then for this period it is absolutely necessary to stop breastfeeding.
Overdose
Symptoms and treatment for an overdose of "Amitriptyline" are almost the same as in the case of other tricyclic antidepressants. Many studies confirm that this drug can be very dangerous in case of an overdose, which is why it is not recommended to use it regularly during the treatment of depression. Among the possible signs of an overdose of "Amitriptyline", it is necessary to highlight such as:
- hypothermia;
- arrhythmia with a violation in the legs of the bundle of His;
- drowsiness;
- tachycardia;
- coma;
- chronic heart failure;
- cramps
- stupor;
- vomiting
For the treatment of overdose with this drug, there are no specialized antidotes. Activated charcoal will help reduce the absorption of the drug, but if you take it within about 1-2 hours after an overdose. If a person is unconscious or has a violation of the gag reflex, then in this case a probe is often used to deliver the antidote to the stomach.
When carrying out all manipulations with the aim of neutralizing Amitriptyline, monitoring of all manipulations with the help of an ECG is required and for the next 5 days after normalization of well-being. This drug increases the inhibitory effect on the nervous system, but does not have an anticonvulsant effect.
special instructions
The drug "Amitriptyline" in dosages of more than 150 mg per day leads to a significant decrease in the maximum threshold for convulsive activity, so be sure to consider the likelihood of convulsive seizures in patients if they were previously in the patient's history.
Therapy in old age must necessarily take place under close supervision with the use of the minimum dosage of this medicine and its gradual increase. This is required so that the development of dangerous complications can be avoided. While taking the drug, it is forbidden to drive vehicles, maintain complex mechanisms, as well as many other types of work that require increased concentration of attention.
Interaction with other drugs
The drug Amitriptyline has a specific effect on the regulatory functions of the nervous system, and also interacts with a number of different drugs, which are not recommended for use in combination with an antidepressant. Monoamine oxidase inhibitors can provoke a syndrome of a sharp lack of the hormone serotonin.
When used simultaneously with anticholinergics, in particular, such as Hyoscine, Atropine and Benzotropin, intestinal permeability can significantly worsen, and there is a likelihood of tachycardia. The use of antipsychotics with Amitriptyline can provoke an increase in the sedative, epileptic effect. In addition, there is a likelihood of fever and an increased risk of malignant neuroleptic syndrome.
While taking with some thyroid hormones, many complications and side effects can develop, in particular, such as arrhythmia and excessive stimulation of the nervous system. Analgesics such as Tramadol in combination with Amitriptyline may increase the risk of heart failure. In addition, it is also not recommended to take "Levodol", as it leads to a worsening of intestinal motility.
Analogues of medicine and reviews
In case of certain contraindications for the use of the drug, the doctor may prescribe analogues of "Amitriptyline", in particular such as:
- Amizol
- “Sarotin Retard”;
- "Elivel";
- Tryptisolum.
They also have a sedative effect and are used to treat depression. It is worth noting that before choosing the analogues of "Amitriptyline", you should definitely consult with your doctor about the presence of contraindications.
According to patient reviews, this drug has several effects on weight gain. Many say that this drug has an acceptable cost and helps to get rid of depression in the shortest possible time.